Fig. 3.

The leaky pipeline for transthyretin amyloidosis (ATTR) diagnosis and treatment. Only a fraction of patients with ATTR are treated. Cardiomyopathy does not develop in all patients with pathologic mutations due to incomplete penetrance. ATTR cardiomyopathy is frequently identified post-mortem, an untimely diagnosis. Until May 2019, there were no approved therapeutics specifically approved for ATTR cardiomyopathy. At a cost of over $200,000, tafamidis remains unaffordable for some patients with high deductibles and coverage gaps